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Newly diagnosed and going hypo and hyper

J

jflynn2001

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Hello folks. My mum had a pancreatectomy a few weeks ago and is now type 1. Her levels are swinging from 2.6 right now to 22 a few days ago and she had to be readmitted to hospital overnight to stabilise things.

I think she is finding it difficult to get her head around the new regime (we all are), but after telling me her level was 2.6 she mentioned she was due to take insulin soon so that was OK...Insulin lowers the blood sugar level so I'm worried taking insulin just now would be the wrong thing to do. Instead she has taken a couple of glucose tablets and eaten half a banana and is about to check levels again as half an hour has passed.

She seems to want to stick to the schedule she has been given for taking her insulin, but it would seem to me she needs to take into account what her levels are as taking the insulin regardless could be very dangerous.

She also had part of her stomach removed and spleen removed. She can only manage little portions of food. The last time she ate was three and a half hours ago and as she was advised to eat little and often I feel like too much time has passed between meals/snacks, I know this can also reduce blood sugar levels.

Does anyone have any advice, my head is spinning from all the info and how to interpret it to be honest. If levels don't improve we will be phoning NHS 24 anyway and it might be the case my Mum has to go back up to hospital again tonight.

Thanks in advance.
 
The advice she has been given is to always have insulin before she eats a meal so she is determined not to eat her dinner unless she has had insulin first. My instinct tells me that isn't right, but I don't know enough about diabetes yet to be confident that she should eat without having the insulin. Feels like a total minefield at the moment.
 
I'm Type 1 but haven't had an operation like your mum so I can't comment on her particular circumstances.

I can tell you what I would do. If my blood sugar was low, I'd correct it first so it went back up to a safe level for me. I may then also delay my meal time fast acting insulin and either have it part way through the meal or just after.

I hope your mum feels more settled soon. My only tips are to test lots, keep hypo treatments near, and look to learn about carb counting (matching insulin to food) as soon as yoyr mum feels up to it.
 
jflynn2001 said:
Hello folks. My mum had a pancreatectomy a few weeks ago and is now type 1. Her levels are swinging from 2.6 right now to 22 a few days ago and she had to be readmitted to hospital overnight to stabilise things.

I think she is finding it difficult to get her head around the new regime (we all are), but after telling me her level was 2.6 she mentioned she was due to take insulin soon so that was OK...Insulin lowers the blood sugar level so I'm worried taking insulin just now would be the wrong thing to do. Instead she has taken a couple of glucose tablets and eaten half a banana and is about to check levels again as half an hour has passed.

She seems to want to stick to the schedule she has been given for taking her insulin, but it would seem to me she needs to take into account what her levels are as taking the insulin regardless could be very dangerous.

She also had part of her stomach removed and spleen removed. She can only manage little portions of food. The last time she ate was three and a half hours ago and as she was advised to eat little and often I feel like too much time has passed between meals/snacks, I know this can also reduce blood sugar levels.

Does anyone have any advice, my head is spinning from all the info and how to interpret it to be honest. If levels don't improve we will be phoning NHS 24 anyway and it might be the case my Mum has to go back up to hospital again tonight.

Thanks in advance.
Click to expand...
You want the Type 3.5 sub-forum on here: it's specially for people like your mum. Go to Browse, Diabetes Discussions.

Control is specially hard for people like your mum. My only diabetic friend is 3c: her pancreas and lots of other bits were removed. But she is getting there. She has to eat to her meter, but she also has to find a diet that she can digest. Even taking pancreatic enzymes, there's a limit to how much protein or fat she can eat. So she sticks to about 30 grams carb per meal. That's not low-low carb, but its a lot better than a normal diet, and she can get some consistency that way.

So your mumneeds reassurance, but then she needs to start documenting everything - what she eats, BGs, insulin doses - on a smartphone app. Then she'll begin to see patterns; and then she'll have the chance if some control.
 
jflynn2001 said:
The advice she has been given is to always have insulin before she eats a meal so she is determined not to eat her dinner unless she has had insulin first. My instinct tells me that isn't right, but I don't know enough about diabetes yet to be confident that she should eat without having the insulin. Feels like a total minefield at the moment.
Click to expand...
Yes, that's right. You have to inject before eating. 15 to 20 minutes is best. Then you avoid the spike. Unless you don't know how much food you're going to get (eg in a restaurant), inject first always.

Good luck.
 
Thanks very much everyone! It is a steep learning curve, and she hasn't had time to adjust really, one day she wasn't diabetic and the next day after the op she was. We don't know anyone with diabetes either so it is all completely new. I didn't even know there was a type 3c, and the folks at her diabetes clinic haven't mentioned this either.

She is very good at documenting her blood sugar levels, how much insulin taken, and keeping a food diary. She got her levels up to 3.9 which is ever so slightly low, I think ideally she doesn't want to drop below 4, then took her fast acting insulin before a meal and a while later her levels were up at 7. She spoke with NHS24 in the end and they advised her not to take insulin during the day, only before bed. I presume that is unless her BG levels are very high during the day. She is going to her diabetes clinic again tomorrow so she can ask them if that is the best course of action or if they would recommend anything else.
 
Type 3.5. Well, that's what your mum's situation is called, and it means her metabolism will probably show particular patterns that are different from those of Type 1. She will need careful care. I really advise you to point her towards that sub-forum.

Not going below 4.0: yes, it's best not to go below 3.8. I don't quite understand what you meant about not injecting during the day. Of course she has to inject whenever she eats - always.

On documenting, if your mum uses a smartphone, the app will give her more accessible and more useful data (and instant analyses, standard deviation) in real time. Have a look at http://www.diabetesconnect.de/en/

In general, your mum will need to be quite assertive in getting the clinic to focus on her specific needs as a 3.5.

Your mum also needs to do a lot of reading. She could start with Gary Scheiner, Think Like a Pancreas.

Okay, over and out.
 
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